Hi all...I have a hospice pt with c diff...I know about using universal precautions and using his own thermometer, is there anything else we should be doing...he has multiple skin tears that are draining etc... how long is it communicable etc...he h...
saribeth replied to Mamanurse62's topic in Hospice
I know that the nurses that work for profit hospices are doing a wonderful job and doing it because they love what they do. In my little corner of the world our VNA is really losing so many referrals to the for profits with their heavy marketing and...
Very curious about medicare's criteria for "continuous care." I was under the impression that it had to be a "skilled nursing" activity every 15 minutes. Could anyone clarify or explain what exactly they require? thanks as always...
saribeth replied to americanTrain's topic in Hospice
What about when a pt is actively dying???? Don't you visit daily???? At our VNA the visits are totally up to the nurse. For documenting frequency in the POC we put 1-5x weekly x13 + 3-4 for sx management.
I have "support meetings" every other month with the team. I play some calm music and we discuss difficult cases. Recently I have been doing some fun things...trivia questions, ice breaker type exercises, we even did a mini scavenger hunt...it is a...
saribeth replied to RubyRN,CHPN's topic in Hospice
well get a load of what we do...our manager heard about this at a reginal meeting...plastic zip lock bags with kitty litter...dump the liquids, pills etc and patches (opened and folded in half) and buried deep in the trash with a prayer:saint: almost...
I had investigated this a few years ago and the amount of petroleum in vaseline is very low compared to what it was years ago...so lather her up and make sure you have a fire extinguisher close by...just kidding:p
We have had really good results with Dexamethasone 4mg bid..it increases appetite and gives them a feeling of "well being" (oxymoron I know)! What about a fentanyl patch starting with 75-100 mcg and the percocet for BTP...maybe with the patch she wil...
saribeth replied to hospiceheart's topic in Hospice
Upon admission we have the pts doc sign the SO...they are already signed by our med director. For our comfort pack SO, even though they have signed off on the morphine etc, we do get a new order if the pt begins using the morphine on a regular basis...
Hi kids...From what I can gather death can come rather abruptly with ALS and at times does not follow the "typical" s/sx of dying...Is that accurate? Any insight would be most appreciative...thanks so much!
This is how we write the orders: SN: 1-5x week and 3-4prn for sx management x13weeks MSW: 1-4xmo and 3-4 prn for distress Chaplain: same HHA: 2h 5x week x13 wks Volunteer: 1-5xmo and 3 prn hope that helps!
I do go to the funeral home if I am close to the pt and family (which usually happens) and I almost always write a note...I do it for me and I know the families appreciate it...professional boundries now that's a very interesting topic...NHPCO just h...
We use lap tops...the program is Clinical Novius but it truly is geared toward home care...they told us from the very beginning that it would not save time and boy were they right!!!!!!! I have a love/hate relationship with mine because at times it h...
We use the FLACC SCALE...We make copies for the families to have in the home so they can also do an assessment...just go on the web and type FLACC SCALE and pull up the Nat'l Hospice and Palliative Care Org site...I could not find it by just going in...
We have a check list...absence of Pulse, Respirations, B/P, pupils fixed and dilated...even when the pt is cold with the waxy color I still go through the VS and really really listen for that heart...sometimes pts have the agonal rhythm that stops ev...
saribeth replied to FireStarterRN's topic in General Nursing
hmmm I am a hospice nurse and I have a very deep faith, however...I only talk about the good Lord above IF a pt brings up the subject and I tread carefully. If I know they are Roman Catholic I would ask if they would like to have the annointing of t...
saribeth replied to skittlebear's topic in Hospice
At our agency we have a check list...absence of P,R,B/P pupils fixed and dilated-all narcotics disposed of and witnessed by______(initialed) we notify the funeral home, MD, DME company, & HHA coordinator. We stay with the family until they remove...
Hi all...I have a pt with Huntington's and he has developed these episodes of "coughing" that last for 3 hours plus and go into the wee hours...he does cough up small green mucous plugs (no fever) but minimal and then it is just clear sputum...one do...
We do cover all meds that are directly related to the hospice dx...even ambien (which does not work for our older pts and it is costly) Our comfort packs are $28 and THE BEST THING but we don't order them for every pt. Sometimes good ol' morphine ($3...